Switching from omalizumab to mepolizumab therapy improved extra‐pulmonary abdominal and cutaneous vasculitis symptoms in a patient with eosinophilic granulomatosis with polyangiitis
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Abstract
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis of small‐to‐medium‐sized
vessels. Both eosinophilic infiltration and vasculitis are thought to contribute to
multi‐organ damage. Some biologics have been used to reduce the required dose of corticosteroids
in EGPA, but no single agent can ensure a complete control of this disease. Here,
we describe a patient with anti‐neutrophil cytoplasmic antibodies‐negative relapsing
EGPA whose asthma control was improved by omalizumab, but she continued to develop
flares of abdominal and cutaneous vasculitis symptoms. After switching to mepolizumab
therapy, her blood hypereosinophilia and extra‐pulmonary symptoms were significantly
improved. Moreover, the dose of daily maintenance corticosteroid could be tapered
off. The experience from our case suggests that biologics targeting interleukin‐5
may be more effective than omalizumab in the management of extra‐thoracic manifestations
in EGPA.
Abstract
We report the clinical benefits after switching from omalizumab to mepolizumab in
an anti‐neutrophil cytoplasmic antibodies‐negative eosinophilic granulomatosis with
polyangiitis patient on her abdominal and cutaneous manifestations.
Eosinophilic granulomatosis with polyangiitis is an eosinophilic vasculitis. Mepolizumab, an anti-interleukin-5 monoclonal antibody, reduces blood eosinophil counts and may have value in the treatment of eosinophilic granulomatosis with polyangiitis.
Publisher:
John Wiley & Sons, Ltd
(Chichester, UK
)
ISSN
(Electronic):
2051-3380
Publication date
(Electronic):
29
November
2021
Publication date Collection:
January
2022
Volume: 10
Issue: 1
(
doiID:
10.1002/rcr2.v10.1
)
Electronic Location Identifier: e0878
Affiliations
[1]Department of Internal Medicine
National Taiwan University Hospital and National Taiwan University College of Medicine
Taipei
Taiwan
Author notes
[*][*
]Correspondence
Ping‐Hung Kuo, Department of Internal Medicine, National Taiwan University Hospital
and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng
Dist., Taipei 100, Taiwan.
This is an open access article under the terms of the
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work is properly cited, the use is non‐commercial and no modifications or adaptations
are made.